CN105556513A - System and methods for personalized clinical decision support tools - Google Patents

Abstract

The use of a medical software platform to collect, normalize, and aggregate clinical data. Supports clinical care and provides research and clinical tools for institutions, healthcare providers, researchers, and patients. The invention provides a graphical interface to customize searches in the database for specified subsets of conditions, treatments or outcomes. The invention also provides a system and method for searching through clinical databases for desired terms which may provide additional information to a physician regarding patient care. Furthermore, this invention facilitates personalized medicine-based practices as relationships between genetics, personal heath data from multiple sources, disease risk and drug response can be more easily visualized and utilized for patient care and research.

Description

For the system and method for personalized clinical decision support instrument

the cross reference of related application

This application claims the rights and interests of the U.S. Provisional Application numbers 61/784,647 submitted on March 14th, 2013, its full content is incorporated into this by reference.

quote and be incorporated to

This be incorporated to by reference mention in this instructions all publications, patent, patented claim and database, as clearly and indicate individually and be incorporated to each independent publication, patent or patent application by reference.

Background technology

Personalized medicine is intended to by carrying out the decision-making relevant to its nursing to optimize with patient data the health care that provides to individuality based on all.The target of personalized medicine is for correct patient provides suitable treatment in the suitable time.How may produce disease with individuality due to clinical, the heredity of individuality or the difference of other molecular data aspects and how tackle the difference for the treatment of relevant, therefore personalized medicine has by being individuality customization health care and improve result and reduce the advantage of cost.

At present, our health care occurs in digital field alternately more and more; But, give in data standard and interoperability and pay attention to very little.Therefore, digital health nursing data is still locked in different healthcare network, and cannot access and become instrument and application type very widely in other industry.The advantage that this tissue result in digital health nursing data is unrealized, hinders the ability that researcher makes discovery, and prevents practitioner to make the informed decision-making customized for the needs of particular patient.

Summary of the invention

In some embodiments, the invention provides a kind of method, it comprises: a) receive search item; B) based on described search item, the result clinical concept identified by the first standardization body level is identified; C) know in the second standardization body level acceptance of the bid the clinical concept correspondence, wherein, the clinical concept of described correspondence has the clinical meaning with the clinical meaning basic simlarity of described result clinical concept; D) based on the clinical concept of described correspondence, by the database of computer processor search electric health record; E) electric health record be associated with described corresponding clinical concept is identified in the database; And f) Output rusults.

Accompanying drawing explanation

Fig. 1 is the schematic diagram of clinical data collection method.

Fig. 2 is the overlapping to provide the Vean diagram (VennDiagram) of new grouping of diagram patient data.

Fig. 3 is the block diagram of the first exemplary architecture illustrating the computer system that can be combined with example embodiment of the present invention.

Fig. 4 is the diagram illustrating the computer network that can be combined with example embodiment of the present invention.

Fig. 5 is the block diagram of the second exemplary architecture illustrating the computer system that can be combined with example embodiment of the present invention.

Fig. 6 diagram can transmit the global network of product of the present invention.

Fig. 7 is from being input to the schematic diagram exporting and how can process data in diagram the present invention.

Fig. 8 is schematically showing of citation form body (BFO).

Fig. 9 is the schematic diagram of Ontology Mapping activity.

Figure 10 annotates schematically showing of the concern decline of (episodenote) to fragment.

Figure 11 is the schematic diagram that between show ontology, semantic concept maps.

Figure 12 is the description of the tissue of three highest level bodies that the example embodiment of platform uses.

Figure 13 is the diagram of the token pool of platform.

Figure 14 is how personalized risk information can be inserted in workflow at suitable point by the present invention thus strengthen the diagram of the example of the patient care workflow in EMR by diagram.

Figure 15 is the schematic diagram of the MO body tree using human diseases body and create.

Figure 16 is the body tree of the illustrative body former generation using human phenotype body " hearing loss ".

Figure 17 is the body tree of the illustrative body offspring using human phenotype body " hearing loss ".

Figure 18 illustrates example search interface.

Embodiment

Personalized medicine is intended to by optimizing based on all decision-makings can made with patient data about its nursing the health care provided to individuality.The target of personalized medicine is for suitable patient provides suitable treatment in the suitable time, and this puts into practice contrary with the Present clinical of selecting to treat patient according to the optimal treatment for group.It is relevant how individual difference in clinical, heredity or other molecular datas may produce disease with individuality and how tackle the difference for the treatment of.Therefore, personalized medicine has by being individuality customization health care and improve result and reduce the advantage of cost.

Described hereinly the invention provides health and fitness information platform, this health and fitness information platform operations clinical data physical layer, and play the function that special health and fitness information exchanges (HIE, HealthInformationExchange).System of the present invention can with following supplier's two-way communication: electric health record (EHR, ElectronicHealthRecord), electronic health record (EMR, ElectronicMedicalRecord), pharmacy medical records (PMR, Pharmacymedicalrecord), health and fitness information exchanges (HIE, HealthInformationExchange), patient's individual health record (PHR, PersonalHealthRecord) system, digital health application and other clinical data sources.Platform can be visited by user interface intuitively by final user, this intuitively user interface allow the figure of search item to illustrate, instead of the parsing of text search character string.

In some embodiments, system and method for the present invention provides process, framework and application, to overcome the common problem be associated with EHR data analysis.The present invention allows in the search and in clinical care effective use of EHR data; wherein these EHR data have and can go markization completely and the data structure of HIPAA compatibility, thus provide the idealized system for sharing and assemble medical data while protection patients ' privacy.

System of the present invention provides the platform for collecting, standardizing, assemble, use and distribute health care data.This system connects with multiple clinical data system and clinical practice, this creates bi-directional data pipeline.The present invention plays the function of the networking storage vault of health care data, and serves as mechanism, patient, go-between between its data and downstream user.As the abundant clinical data resource centered by patient, the realization of research tool that the present invention's perfection is suitable for being designed to supporting the software application of personalized clinical care (such as clinical decision support) and runs on this data structure.

User of the present invention can form the health care data ecosystem, and health care stakeholder can develop, shares and use application of the present invention and function thus, to support clinical care and research, and to share the information of body index.User of the present invention can be health care supplier, such as hospital, hospital administrators, contractor of hospital, clinician, paramedic, insurance company, government organs, government bodies, researcher, sanatorium, school, community health tissue, military establishment and supervisor mechanism.Communication between user and system of the present invention can be carried out according to any communication protocol comprising such as the following: USA, Wi-Fi, bluetooth, TCP, EnOcean ^tM, WiMax ^tM, ONE-NET, ANT, 6LoWPAN, Wibree, WirelessHART, and rely on the agreement of IEEE, such as Z-Wave ^tMand ZigBee ^tM.

clinical support facility and application

Present disclose provides method and computer program product, these method and computer program products have the application in health care data management, research, coding, charging and population genomics.Platform of the present invention can utilize clinical object logic (CLO, ClinicalLogicalObject).CLO can based on the combination of attribute and value or mutual.Such as, attribute can be for the kind of the useful information of triage, such as phenotype, genotypic, geographic(al), socio-economic kind.Attribute also can be the addressable concept of layman, such as sex, age and blood pressure.Attribute can have temporary transient value, such as, at a time point, and systolic pressure >140mmHg.Alternatively, value can be lasting, such as, within the time extended, and systolic pressure >140mmHg.Thus, based on basic value, CLO can be temporary transient or lasting.The Organization of Data that CLO can be used for clinical, genome, molecule, environment and patient to report is in the data framework of definition.CLO can with useful, across EMR, across mechanism with go the mode of markization to extract, store and distribute the data of relevant clinical, genome, molecule, environment and patient's report.

Can assess CLO independently, or divide into groups, trooping or jointly assess in colony.These collections of CLO can be replaced checking Data Entry as the collection of individual patient and accelerate to analyze by the similar Data Entry checking based on user's characteristic interested.Such as can organize trooping of CLO by anonymization bar code, each expression individual patient of described anonymization bar code.Such as can by carrying out organizations by recording the logical operator (such as, Boolean logic) linked together.

CLO can carry out organising data to be specifically inverted level, and this is specifically inverted level and is stored as center with the information focusing on particular characteristics or individual patient.Such as, system can use following level: fragment > chart body region > doctor's advice/result/observation/annotation that patient > nurses.Such structure can become the basis of the tissue of electronic health record (EMR).CLO can also provide the inversion level by the data-driven be incorporated in CLO, such as: value > attribute > patient > date/time.

This inverted structure provides to CLO like share class or reasonably with the fast identification of the PATIENT POPULATION that is feature of CLO like such.This level can be accelerated for population analysis, quality report and find the data from the relation in the data in very different territories (such as h and E) to produce, this is because data analysis drives by the clinical value comprised in EMR and PMR instead of by patient identity.

Electronic health record (EMR) can be other facilities of patient with the doctor of main body, clinician, insurance company, hospital and/or main body or be obtained by individual health record (PHR) and the record stored is relevant.Electronic health record (EMR) such as can comprise: cat scan, ultrasonic, blood sugar level, diagnosis, allergy, laboratory test results, EKG, drug therapy, every day chart, Drug use administration, Physical evaluation, to be admitted to hospital nursing points for attention, nursing care plan, change the place of examination patient, now with symptom in the past, medical history, life style, Physical examination results, test, operation technique, treatment, medicine, leave hospital, history, daily record, problem, check result, immunity, to be admitted to hospital points for attention, to succeed record, progress note, preoperative points for attention, operation annotation, Postoperative item, process points for attention, delivery log, postpartum points for attention, genomic data and record of leaving hospital.

Pharmacy medical records (PMR) can be relevant with the record of the pharmacology history about main body.In some embodiments, pharmacology history can comprise the prescription history of main body, current prescriptions scheme and side-effects information, such as, dosage information, main body have taked the time span of prescription, and the known other drug causing negative side-effects together with the current prescriptions scheme of main body.

System of the present invention is incorporated with go-between's function (brokerfunction), and this go-between's function can make data anonymous or go identificationization, with hiding individual and authority identifier.Then data can be associated with the bar code of anonymization, and data are associated with the designator of personal identification by the bar code of this anonymization.Go-between's function can contact (encounter) actual dates from health care creates a date deviation, thus provides higher privacy class.

Another aspect of the present invention relates to the method providing clinical support facility and application, the convenience that this clinical support facility and application improve to the use of genome sequence in patient care.The nearest progress of technology has substantially increased the understanding of the genomic constitution to various diseases, and researcher is finding gene, contact between environment and the hereditary disease of complexity.The invention provides for the classification of genomic data and the clinical support facility of application and application.

A large amount of gene variants has been identified in the genome (comprising human genome) of sequencing.Variant may have functional sense, such as, causes the missense mutation in protein coding gene or nonsense mutation.Variant may not have functional sense, such as silent mutation.Single nucleotide polymorphism (SNP, Singlenucleotidepolymorphism) may have functional sense.System of the present invention can provide clinical data physical layer, and this clinical data physical layer improves the convenience needing the use to these data for clinical and research.

metadata management

As centered by patient, data rich in natural resources, the present invention is ideally suitable for being designed to supporting and the realization of clinical practice of assessment clinical care.Can across a network, particular organization place or supplier or client layer place implement some rule.This is functional can be used as in order to ensureing that consistance is put into practice, report and the driver of charging.Can realize clinical decision support (CDS) application, thus make doctor can at the reception made a policy to the recommendation to best practices, its Seamless integration-be in existing clinical workflow.

The present invention comprises metadata management tool set, and this metadata management tool set allows organization data source to define its inbound data structure and form, to promote to take in from the data of source EHR system.

The present invention comforms multimachine structure and setting and seek data by end user's typing.Between their coded data, interoperability is shared owing to not needing data source, and this type of interoperability does not cross over the possibility of free textual data entries natively, so the present invention provides semantic interoperability by using the Ontology Mapping of various open-source and proprietary biomedical body (biomedicalontology).By this way, such as can be integrated in CLO with the information of ICD-9, ICD-10 and SNOMED coding, and not consider to locate in data source mechanism the coding structure that uses.

Because Ontology (semanticontology) is the center infrastructure component of data framework of the present invention, so using mechanism, supplier and researcher by its door and a lot of metadata of providing are caught as the ontology expansion to known body separately, wherein a lot of have been openly available expansion and managed Ontology.The present invention provides semantic interoperability by using the Ontology Mapping of multiple open source code (disclosing) and proprietary biomedical body.This tissue creates the nested of various body configuration, thus result in internal consistency and interoperability.Relevant system requirements can comprise definition transmit data set framework, structure and content, data structure are mapped to the distinctive data configuration of the present invention and framework, and the use of specified value syntactic structure (such as, HL7, CCR).

data import and management

A series of stage will be passed through from the Data import participating in mechanism.After only experiencing minimum data and cleaning or change, the data directly taken in are loaded into absorption data sectional warehouse of the present invention.Direct absorption comprises the data of any door directly entering into any customer-oriented door (portal).Data enter into CLO data warehouse from clinical warehouse.

Data take in the authorities data of process from registration, and by data sectional in absorption data sectional warehouse.The emphasis of absorption process ensures correctly to catch all data from mechanism, can review the source of turning back to completely, and capture-data in a particular manner, and which is supported in data in subsequent treatment to the mapping of normalized number of the present invention according to definition.

System requirements can comprise the Data import carried out according to the information that provides in metadata management function, which ensure that the quantitative data of arrival is in predefined metadata or have the term of reference of definition in feeds of data self.Data are taken in process and taken in data are advanced in CLO environment of the present invention.The output taking in process is the set of " unit CLO (UnitCLO) ", the data pin of absorption can be mapped it.In some embodiments, will not map among absorption data set or Unidentified data move forward in CLO.In order to increase quality control, system requirements can comprise for standardization term of reference of the present invention, ignore from the invalid and unmapped data taken in, standardize in quantitative data, and guarantee that normalized number gets back to original source value according to can directly review.

Both gathering rules that the gathering taking in data can be specified by gathering rule and the user based on body drive.The output assembled comprises the CLO of complexity arbitrarily and trooping of patient data.User can create the gathering (aggregate) of any complexity, inclusion or comprehensive rank.

System requirements comprise: implement CLO rule for the new data taken in, identify based on newly arrived data and make a change existing CLO, and renewal is pre-defined and (aggregateCluster) is trooped in existing gathering.These rules (rule) can be created by user, and are loaded in regulation engine.Whenever when rule is triggered, can instruction regulation engine application rule.Such as, trigger when the record of rule encoding Cheng Xin can be created, or trigger when existing record is updated.When the project of specifying or its body equivalent enter into record, or when being used as search item, rule can be activated.Once be activated, rule can application result, such as, sends warning to user, send warning in system-wide, stop access, stop the typing of record, stop the renewal of record, denied access, creates report, provides clinical support to instruct, or request emergency aid.

Fig. 7 provides the illustrated examples in above-mentioned stage.As shown in Figure 7, the data from mechanism, supplier and researcher will pass through a series of stage before final output.In the stage 0, take in data.Abandon bad data value, those reservation are standardized, and is traceable to particular code, thus create the first stage of Ontology Mapping.Between stage 0 and stage 1, apply the conversion knowledge from system, to be defined for subsequent treatment in CLO to data by data-mapping.In the stage 1, start the objectification of data, the data taken in thus are transformed in the set of unit CLO.Start in the gathering in stage 2 and stage 3, CLO.Data gathering not only can be guided by the gathering rule of basic body, can also gathering rule defined by the user guide.Data after gathering are rendered as CLO and troop.Final stage in data management path optimizes.In this stage, created CLO is converted into the form of the various the features and tools that can be used for platform with trooping by program.This process is normalized, and can reproduce on high fidelity ground, to allow to carry out organising data according to common access path, finally optimizes the performance of the system for final user.

assemble worktable

New data rule beyond the data rule that " assemble worktable (AggregationWorkbench) " of the present invention allows stakeholder to define to provide at baseline.Data Structures can be combined to and troop in gathering by user.These gatherings can be client definitions, and can utilize ontological relationship available in worktable and knowledge.Such as, in order to assemble the patient of age between 16 to 18, user can define such aggregation capability, this aggregation capability by the definition age be 16,17 or the unit CLO of the patient of 18 years old put together.It is 16,17 or the trooping of the patient of 18 years old that the behavior creates for the age.

Fig. 2 provides from the illustrated examples for creating the user-defined CLO newly trooping and assemble and the Data Structures created.Such as, if user is searching for the age and is falling into the patient with particular diagnosis (410.01) in age-specific reference range (45-49), then this user defines aggregation capability, and the patient defined by the CLO comprising this particular diagnosis and the range of age puts together by this aggregation capability.This strategy creates has diagnosis 410.01 and the trooping of the patient of age between 45 to 49.

interface

" clinical decision support (CDS) " tool set allows the present invention synchronously or asynchronously mutual with the electronic health record system (EHR) of mechanism when nursing, so as to use in knowledge base and CLO warehouse can data to strengthen nursing time clinical data value.System requirements can comprise various clinical and based on the application of standard of research, and support known or by studying the guide defined.The present invention can provide warning to final user in real time, and patient is still on the scene simultaneously, or can send warning by other mechanism comprising Email and SMS message to final user at other times.Systemic-function and feature are included in when will nurse and support multiple conventional synchronous and asynchronous agreement, and with the EMR application integration of existing usual realization.

" such a patient " of the present invention (PLT, PatientsLikeThis) tool set comprises a set of application, the application of this cover allows visit to end user CLO warehouse, to identify Therapeutic mode and relevant result in warehouse widely between patient clinical population, to identify the patient similar to the patient on the scene when looking after, with create or realize clinical decision support (CDS) rule or for studying application.The grouping with designated value with the patient being feature can be generated in user interface, and carry out constriction or expand to obtain the recording interval expected.Then in the grouping of " such a patient ", carry out search become possibility, so as to know may be relevant to other information with class likelihood data information.Such as, when providing therapy to the patient with specific indication, doctor can search for " such a patient ", knows what therapy is used for this indication in the hospital of this doctor at present.This instrument also allows the quick collection to research information, and these research informations are definitely limited to the patient class that user finds easily.User also can generate the rule being accurately applied to " such a patient ".System requirements can comprise supplier's profile of asking known clinical observation, supplier's weighting of request known facts, and analyze CLO and troop to obtain similar case and data.

" query facility " of the present invention allows user to visit CLO data according to the different identification rank of its IRB profile or other regulatory approval and to troop, thus allows exploration or the definition of interested colony.Query facility can exist as graphic interface easily, and it allows user to illustrate search item, such as CLO search window by clicking on research tool, and over the display so that build the mode fixed-position searching instrument of search.A lot of research tool can be positioned on screen and according to the requirement of user and reorganize.Search item can be entered in research tool, and described instrument can be connected by logic, sequence, date or temporal calculation symbol.Can illustrate that described connection is made in connection by figure, such as, by drawing line, curve map or geometric figure over the display to make.The pattern connected has implied the relation between search item.User can typing operational symbol, and such as, boolean calculation accords with, and carrys out the desired relationship between specified search term.The computer system of working procedure determines search strategy by the graphics relationship between decipher search item AND operator.Then the inquiry based on typing performs search, and does not need text search character string or the process searches logical OR code of user's complex structure.

System requirements can comprise mark target population or colony, and application patient demographic (demographic) and geography filter, and by CLO model extraction complexity.Additional demand can be the order of temporal sensitivity to dependent event and data element.During systemic-function and feature can comprise and the query criteria of complexity to be integrated into and to troop, and to using the use of meticulous ability of high inquiry degrees of specificity.

" management and control and revision " of the present invention tool set allows authorized user manually to add annotation and be connected between its data element, to strengthen data and the target customized information according to user.System requirements can comprise semantic and taxonomy data set or body interpolation, and arrange the ability based on the threshold value using the case revised for necessity of private data.Systemic-function and feature can comprise natural language processing ability to analyze free text material.

" data delivery " of the present invention tool set allows authorized user to define and receives from data set of the present invention, and described data set can use more partly then in the specific instrument of client and environment.System requirements can comprise data delivery mechanism flexibly, and when sending, standardized data are converted into target framework.Systemic-function and feature can comprise the standardization exchange using known Standards and formats.

" instrument panel and Card " of the present invention tool set can be provided to the observability of environment of the present invention, so that monitoring and controlling data and process constantly.System requirements can comprise the grade focusing on client and data, the form of use, and financial tracing and managing.Systemic-function and feature can comprise the inquiry of the control data by push-pull mechanism.

internal control

" honest go-between " of the present invention function provides the basic functionality needed for identifier hiding patient, supplier and mechanism for safety; Each is changed into the token--identifier that will use in all CLO data structures.Except identifier anonymization, go-between additionally provides the skew of grappling date, and all date and times in CLO structure are the assumed name according to the skew of this grappling date all.

Table 1-is honest, and token ID maps to token.The table show the ID of the ID type MRN for hospital A, this ID has been assigned with the token 356749 with skew August 18 2004 date.This token--identifier can use in all CLO data structures.

System requirements can comprise another name aligning, identifier merges (A34), conflict management, authority notification and synonym.In addition, system requirements can comprise for each registration participant assignment agent identifier, and agent identifier are mapped to the identifier of each different or local in data source.Systemic-function and feature can comprise orphan's process and control.

Process of the present invention and quality management provide such instrument and function, and it is intended to ensure that data in platform and cross-platform managed help in support & participation tissue and the high-performance participated between tissue.System requirements take the photograph pursuit before can comprising the suitable nursing to patient, and population management is filed, inter-organization patient/medical record management, and benchmark care guidelines maps and report, and the support to PN demand.Systemic-function and feature can comprise inter-organization patient and supplier's tracing control.

" yield management tool " of the present invention function can provide finance price, regulation and the observability compensated to tissue, supplier and participation patient and control.System requirements can comprise inner accounting, Using statistics, client's payment and stakeholder's incidentals.Systemic-function and feature can comprise the realization of coding contract and pricing mechanism.

customer-oriented door

Customer-oriented door be the present invention to the exterior face of organized stakeholder.Such as each class stakeholder of mechanism, supplier, researcher and patient has its oneself portal interface, provides service by this interface.All doors share the service of the constraint being subject to its access rights, option and data access.

" mechanism's door " of the present invention can be network interface, carries out alternately for health care and research institution and service of the present invention.The main collaborative point that this door can be the present invention and participate between tissue, other suppliers most, patient and customer service to occur in this door set up and have in the context of mechanism's relation of document.Participation mechanism provides the access to its EHR and other data sources, and the coordination technique contact for setting up suitable data transfer protocol.

Service available in this door and the non-limiting example of order comprise following content.Be registered as mechanism: from academic medical centre to the mechanism of little clinical practice, to profit-generating medical treatment and Health Research Co., can be registered as in the present invention and participate in mechanism.These registrations are served as and are carried out for supplier, patient and researcher the anchor point that contacts.Log-on data source: the mechanism of registration can provide the information relevant with its patient data storage vault, to start integrated for itself EMR or EHR application data to the process in environment of the present invention.There is provided metadata: the mechanism in log-on data source can provide the sufficient metadata relevant with these sources, can be treated correctly and decipher to make the data transmission between these system and the present invention.Title supplier: the individual supplier that can identify the mechanism with registration, to promote that it is registered the individuality of function of the present invention and ability and use.Definition rule maker: no matter whether the individuality at place of each mechanism, be named as supplier at these places of mechanism, can be identified as about the rule author that the policy between this mechanism and the present invention is arranged and agreement performs.Release patient data: once patient has authorized license allow that they so do, mechanism just can discharge patient data to the present invention.

" provider portal " of the present invention is network interface, carries out alternately for health care supplier and service of the present invention.Most activity comprising nursing related alternately, when comprising nursing decision support and alert message movable, or as the rule of the forerunner to sort of activity and preference definition of activities.Supplier (such as, doctor, pharmacists) proposes the main regulation being used for nursing stakeholder market of the present invention.For the object of the diagnosis and informationally efficient that utilize its knowledge base and instrument, supplier can carry out with the present invention alternately.

Service available in this door and the non-limiting example of order comprise following content.Be registered as supplier: can be registered in service of the present invention by the supplier of mechanism's name of registering.Invite patient: supplier can provide it to want to invite the list of the patient participating in crowd's ecosystem of the present invention.Definition rule: supplier can the rule of definition its oneself in the middle of available service option and supply to be combined with the present invention and to develop in time.License: supplier can be effective to any or all of function authorization of the present invention in accessing in its practice and patient.The schedule of patient's access: the schedule of patient to the access of supplier creates chance to check and upgrade the patient information comprised in the present invention.Implement patient's access: supplier can usually be accessed by its registration patient, thus creates chance to add the additional data about these patients.ADC/IDC: clinical data when can catch nursing by integrated or asynchronous data capture technique, the registration supplier that this data capture technique and mechanism locate applies direct interaction.Receive warning and notice: supplier receives warning and the notice with contextual meaning from the present invention when nursing.When a lot of message in these message are accessed from patient, supplier can asynchronously obtain, the future development sent towards real-time messages along with technology maturation.Check similar case: supplier can for the clinical similarities between other patients (PLT) defined in the patient nursed during nursing and the present invention to inquire about the present invention.

" patient's door " of the present invention can be network interface, carries out alternately for patient and its service.Although patient its oneself regularly can find the present invention, patient most possibly can access this door in response to the one or more invitation in its health care supplier mechanism.User interface makes process become easy to patient intuitively, makes them want to participate in service and the activity of possible range the most widely; Comprise and its oneself health care data is provided, agree to participate in the Data Collection by its all health care supplier, and promise to participate in any service of contact again provided for the interests of institutional client suitably.

To the interested patient of service of the present invention can with tool set direct interaction of the present invention, this is usually only as the mutual result of supplier, the baseline of identity data in knowledge base of the present invention after carry out.Its data of Patients' rights, even if therefore using knowledge base and instrument under the sight providing nursing supplier, each patient also can authorize license to supplier like this.And, patient also uses instrument of the present invention independently, direct typing and safeguard its oneself demography and health data (molecule, demography, environment, phenotype or genotype), and the link of its oneself the individual health record (PHR) storing or safeguard outside any participation mechanism of the present invention or supplier.

Service available in this door and the non-limiting example of order comprise following content.Receive and invite: patient can receive and invite with making for registration based on its supplier, and the mechanism of described supplier registers in the present invention.Be registered as participant: individuality can be registered as participant in service of the present invention, this can be direct, or the result of the invitation that can provide as registered mechanism.There is provided preference: registered participant can provide and safeguard that it is for a lot of function and the preference of data interaction that occurs between the present invention and associated provider.System of the present invention can be driven by patient's preference to a great extent and control.Register in project/problem: patient can select to register in particular studies problem, these particular studies problems have invited these patients, this is because they meet the standard of the content in project research, and these patients had previously indicated class target and the wish got in touch with for this reason.Receive summarized results: the problem that participates in or project can have been selected to provide summarized results to patient from patient.Authorize license: patient can provide the specific license for the data that can be exchanged by the present invention and its registration supplier and be managed.Control is retained in patient's hand by this type of license, and benefits from dark granular level, make patient for who see they data and according to what level-of-detail, retain whole controls.Management personal data: patient can provide and safeguard its personal information in platform, comprise as the patient information from multiple participation mechanism being carried out to unified result and mediation to contingent contradiction and data collision.Access provider: when patient accesses its supplier, these access can be carried out with the present invention alternately in such a way: which is visible to patient, or may remain on backstage.Reception notification: the present invention can generate interested notice to the patient of registration.There is provided and check data: patient directly to the invention provides data, and can have the ability of checking its all data.Participation mechanism: some data that patient directly provides may be in response to the mechanism that provided by the mechanism of registering (supplier or researcher).There is the network of participant: the present invention can provide limited social networks ability for the patient of registration, supplier and researcher.Receive and compensate: patient can receive under profit-generating shared agreement of the present invention, the institute for its data identify the compensation of use, and direct for the compensation participating in contact activity again.

research door

" research door " of the present invention can be carry out mutual network interface for health care correlation analyst and researcher and service, and relevant analyst and researcher are from both non-profit-making part and profit-generating department.This door allows access colony and population analysis service, and to define the ability with access data sets based on the various identification level of IRB state, for the other problem outside environment of the present invention.

Researcher represents another major benefit relative in products & services of the present invention.Just using supplier of the present invention unlike for providing nursing, researcher's usage data and instrument are using the part as its oneself problem methodology.Researcher can short-term and being associated with mechanism and research team chronically.

Service available in this door and the non-limiting example of order comprise following content.Be registered as researcher: the researcher named by registration unit can register in service of the present invention.Management alliance: the individual researcher worked together with the researcher in unafilliated mechanism can end-to-end or with the rank of project/problem to manage those relations.Registration project/problem: researcher can register its project, starts the process of the IRB approval of the service obtained for usage platform in its research.There is provided standard: researcher can be provided for inclusive criteria and the exclusion standard of its project or problem in the process of closely imitating IRB data access definition.Identity colony: researcher can define colony's definition, and for studying and controlling to search for colony in data of the present invention.Obtain data set: researcher can receive from the present invention and be used for the data set that its IRB ratifies problem, and described approval problem is for agreeing to the patient participating in these problems.Definition rule: supplier can safeguard its rule for the data input and output of the information relevant to its problem of supervision.Management and control data: researcher can the data of management and control its oneself in the system of the present invention.Reception notification: based on its oneself predefined rule, system of the present invention can provide notice and warning to researcher.Receive and infer: when implementing the continuous analysis to the data in the present invention, the standard that certain pattern may provide with researcher matches, infer to generate work according to the correlativity found out in data.Check and infer colony: by identified patient's standard, researcher can see the profile of the work group matched with the case standard of its statement, thus provides the supposition version of the PLT ability towards supplier.

handling implement

" utilize monitor " in platform provides so functional: the service level monitoring subsystems of the present invention, any adjustment with the effective of support maintenance environment of the present invention and tool set and needed for high performance operation and amendment.The internal trace that system requirements can comprise loading, request, inquiry and data are downloaded and supervision, and what function and feature are being used to whom and is having and many to follow the tracks of frequently.Systemic-function and feature can comprise security and privacy audit.

message sends and workflow engine

The sequencing of the round message between " message send and workflow " function controls serve platform and participating in, priority and tracking, thus guarantee that all working stream is alternately and the end-to-end continuity of message signaling.

The center of the data between door and participant data set and the mission being door that communicates of both advisory message.Controlling these workflows to follow the tracks of enters into or leaves all data of the present invention and benefit from and identify process check point, can be set up by support employee at described process check point and monitor daily record, to guarantee completeness and the validity of all working stream.

System requirements comprise with the interactive sessions of supplier EMR initial, follow the tracks of and stop, the priority of the message of all generations, the generation of the message consistent with the preference that participant states, the notice generated and alarm aging, and the resending of certain high-priority message lacking expection action or response.Systemic-function and feature can comprise monitoring data and to trace to the source stage and loading, and disconnected in a session after control message forward.

Identification function of the present invention ensure that and uses all users of function of the present invention and service and participant appropriately to be identified in each interaction point and differentiate.In addition, can to surround all functions mutual in the control of state-of-the-art.

System requirements can comprise providing singly logins ability by multiple interface.Systemic-function and feature can comprise component society's media model and framework and standard.

managerial ability

The data manager of platform can be responsible for data standard, the definition of conversion and structure and maintenance.Service available in this ability and the non-limiting example of order comprise following content.Model data: data manager logically can carry out modeling to the data in system of the present invention, to ensure that data from multiple source are by integrated and internalization rightly.More new metadata: all stakeholder relies on and uses the metadata of service of the present invention can based on usually monitoring the ongoing change of data and interpolation and the rule that provided by different interests relative and safeguard as a whole.Promote supervision: the operating parameter of operation of the present invention submits to high level supervision decision-making.Management and control data: change based on data modeling, rule or simple data abnormal, the data that data manager can regularly manage in management and control network.Management body: because as a rule can Ontology still imperfect, therefore individual entry and map may be mapped in platform; Particularly occurring across multiple data source and body in the solution conflicted.Control data quality: data manager can the quality of data in monitoring and controlling the present invention, and takes necessary step to improve when data quality problem occurs or correct them.

system is supported

Support team of the present invention is responsible for all clients' contacts in the regular job of door and service location.Service available in this ability and the non-limiting example of order comprise following content.Enforcement policy: support team member implements the various policies that supervision main body proposes, a lot of programmatic realization needed in system of the present invention.Problem: project and problem need when carrying out defining and managing in its life cycle to implement when needing data along with the time and security changes.Attract user: user of the present invention may need to support often, the relatively disclosed user particularly representated by patient.Management loads: the Data import from multiple system and application may need the management by registration, metadata and ETL process.Management notice: the warning in system and notice its along with the time aging or along with aging and cancel time may need management and intervene.Management data integrates: the data set as researcher's establishment probably stands the control can carrying out managing beyond the technological boundary of platform.Monitor performance: can monitor that the performance of process of the present invention is to ensure to send enough service levels to all stakeholder, particularly along with the time needs the intensive analytic function of the more processing of the system of scalability.

control audit

" audit person " of the present invention is responsible for guaranteeing to set up good control by all products & services, and the auditing possibility clause of agreement between door stakeholder of the present invention can to utilize in door can data support.Service available in this ability and the non-limiting example of order comprise following content.Evaluation control: the various controls that audit person can be in place in Evaluation Platform.Assessment loads data: audit person can use agreement according to suitable data and authorize license and assess all Data import.Assessment visit data: audit person can the appropriateness of all data accesses in evaluating system.Quality of evaluation data: audit person can the quality of all data in evaluating system, and relevant removing agreement.

official HIPAA

" official HIPAA " of platform is responsible for the compliance of all door products & services, and plays the part of the role confirmed the HIPAA compliance of all door participants of the present invention.Service available in this ability and the non-limiting example of order comprise following content.Policy is set: can control by with the policy set by the system level for HIPAA compliance for controling parameters of the present invention.Assessment agreement: can check that data use agreement and project planning for compliance.Monitor and use: all data accesses in the present invention will come under observation and check.Monitor compliance: can for institute's protocols having is specified and the compliance of control policy to monitor the overall compliance of system of the present invention.

data are supervised

Data monitoring function of the present invention provides along with the time is to the policy control of door products & services, comprises to deployment criteria and client's abnormal function and serves relevant decision-making.The non-limiting example of the order of service available in this ability comprises following content.Policy is set: supervision main body of the present invention arranges the operation policy realized by a series of controls (such as, reference event) running through platform.Make service point priority: supervision main body arranges the priority for realizing and spread out the present invention's extension feature in time.Monitor abnormal: all exceptions of the supervision of supervision main body and the operator scheme assessed expection and agreement, find the chance that products & services are improved.

ontology management

Body embodies the clinical and operative knowledge being defined by practitioner group more widely and safeguarded, thus allows the knowledge and the practice that the present invention is based on widest range, and does not need this type of specific knowledge by the management and control of the present invention own.Body provides semantic harsh rank, and it allows this software to handle this type of knowledge by this way, in described mode, only systematically derives effective connection and conclusion.

Platform can use various body in search and data record.Can safeguard or searching record in one or more body.Platform can be safeguarded for the mapping block of track project across the Ontology Mapping of multiple different body.Mapping can be carried out inside and upgrade, or is upgraded by external contribution person.Mapping provides fast and resource easily, and platform can rapidly laterally and vertically search for, to find the project with basic simlarity or basic equivalent clinical definition by described resource.Mapping block also by serving as translator and allowing each mechanism to search for and understand the data of other mechanisms, and promotes the communication across the mechanism using different body.

open biomedical body (OBO)

Body is the expressing for knowledge relevant to specific area.Character between the knowledge that specific area uses the vocabulary shared to represent the different aspect comprised in this field and relation.Clinical and the operative knowledge relevant to health care practitioner group can be embodied in this field.In order to the various semantemes that different institutions and researcher use are described, platform use widely body to comprise knowledge and the practice of maximum magnitude.Platform such as can use open biomedical body (OBO) to manage its Ontology Mapping.OBO standard defines one group of principle for using three other ontology management language: XML, RDF and OWL.OBO is that the interoperability of multiple body provides additional harsh degree with compatible, thus allows internal consistency and outside compatibility.

Used the harsh Ontology of OWL standard development, this OWL standard is the lifting to adapting to the early stage RDF standard that the XML of ontology development constructs.Owing to relating to these language, therefore for which are added specific label characteristics, described label characteristics allows to represent semantic knowledge in mode harsh gradually.OBO standard---and non-language correction, but for using one of such language group of principle---with the addition of the additional harsh degree relevant with compatibility with the interoperability of multiple body.The body complying with OBO can be inner consistent, simultaneously also with other the body harsh ground interoperable complying with OBO.Two bodies complying with OBO cannot be inconsistent each other, also do not have possibility to attempt to define identical concept.Its internal relations can carry out external definition in OBO relation body, makes the identical relation across body can have similar implication.

The center of complying with in the body of OBO controls to be the demand that all relations defined in the body complying with OBO use the relation defined in OBO relation body (RO) usually.RO solves and is using one of risk maximum in ontology navigation knowledge base, namely, use the semantic meaning of the relation of same names may be inaccurately consistent in different body, and may be to mislead or incorrect by the conclusion that reasoning draws across the connection of this type of relation.Multiple descriptor can be used to specify relation, if necessary, described multiple descriptor can be further subdivided into more accurate descriptor.

By the available relationship storehouse requiring all Ontological knowledge shares identical, logically can navigate to different bodies across these bodies, and there is no the risk that the semanteme hidden changes, the thread of the logic caused in data assessment is become incorrect by this semanteme change of hiding.

Another strong control of complying with in the body of OBO is such demand: all resources defined in body finally can trace back to citation form body (BFO, BasicFormalOntology) one of structure defined in, the body of explication serves as the higher level body of the grappling resource across knowledge non-individual body.The world is divided into continuous things by basic body, and---things---with accidental things---continued in time occurs in good time or in time.Continuous things can transfer to participate in accidental things, revises the dependency characteristic of these continuous things.

Fig. 8 is the visual representation of the BFO being divided into continuous things and accidental things, and those entities wherein in continuous things are lasting in time, and those entities in accidental things are not whole existence at single time point.Continuous things is further subdivided into area of space, independent things continuously and is relied on continuous things.Area of space segmentation comprises the dimension entity continued in time.Independent things is continuously those entities not needing other support just can exist, and rely on continuous things and need support in order to exist.Accidental things is divided into procedure incarnation, spatio-temporal region and time zone.Procedure incarnation is process section launched in continuous time.Spatio-temporal region is the entity existed as the function of room and time, and can be interval, along with the time occurs, or moment, only occur at particular point in time.Time zone is only as the entity that the function of time exists.

ontology Mapping.

Ontology Mapping is the core component of the CLO definition in the present invention.Because data representation represented in the CLO example of real world clinical information, the real world example of the data of the type therefore mapping main structure represented from clinical body and those types being mapped to classification obtains.

The example of such Mapping activities illustrates in fig .9.The left-hand pane of this figure illustrates the body entry being defined in the various type of codes occurred in data record.Clinical code is different from demography code.In the field of clinical code, diagnostic code is described in ICD-9 and ICD-10 diagnostic code.The relation (" being a kind of ") being used for defining these relations is within multiple key relationship of using when sorting out body.It is the diagnostic code with dissimilar implication that mapping illustrates ICD-9 and ICD-10; Thus, the list of the example is non-intersect.

The right side pane of Fig. 9 illustrates some examples that can define for the classification body in left-hand pane.ICD-9 ontology definition on the pane of right side to sort out the example of structure represented in body on left-hand pane.Provide code 410,410.0 and 410.01 all as the example of ICD-9 diagnostic code.A part such as by be defined as 410.0 by 410.01 illustrates the relation between example, this 410.0 be defined as 410 a part.By such relation " part ", the diagnosis of 410.0 or 410.01 is also the diagnosis of 410, but otherwise may be false.

Table 2 provides the non-limiting list of the body level being suitable for using together with platform of the present invention.

take in data sectional warehouse

" taking in data sectional warehouse " of the present invention is the picked-up reservoir of all data from mechanism's arrival of registering, and is take in data sectional warehouse on a large scale.This serves as the work space of Semantic mapping on the one hand, and the set of source data of the establishment of serving as CLO and loading.

The data taken in data sectional warehouse can be safeguarded with the form of the semantic instance in the body comprised in the present invention, and therefore data are related to the further process in CLO and the instance data of arrival is mapped to semantic type represented in these bodies, make the semantic relation comprised in these bodies can be used for refining data and by packet in CLO, CLO is the information entity of ontological.Data comprise to the non-limiting example of the mapping of type: as people's (object) of independent things continuously; As the patient (role) relying on continuous things; As the supplier (role) relying on continuous things; As the age (quality) relying on continuous things; As the systolic pressure (quality) relying on continuous things; As the contextual medical access of process; Participate in the patient of medical access; Participate in the supplier of medical access; The age that people is intrinsic; And the systolic pressure that patient is intrinsic.This type of Semantic mapping is provided in CLO useful in platform together with data normalization.

cLO data warehouse

" the CLO data warehouse " of platform comprises summaryization in advance and trooping in the colony that identified of normalized CLO and being grouped into, and the described colony identified produces from whole object process.Accurate adjustment can be carried out for supporting the High Performance Data Query of further research to this structure, thus provide basis for cross-platform data functionality.

safety/discriminating

User ID and password may be needed to visit door ability of the present invention for participant.These access credentials by Altitude control, and can be limited by quite harsh renewal and access constraints.As from the storage vault across mechanism and individual data, can differentiate that the ability of any portal user is optimized, to improve patients ' privacy to the object for access control and function mandate.System requirements can comprise the user's discriminating using unique identifier and password, to the access through the function of permission and the based role of feature, and the account valid period from inertia or abuse.Systemic-function and feature can comprise supports password prompt and regular forcibly changing, and allows mechanism releases from the mandate of supplier and researcher.

user training and support

The present invention can be used by multiple user, and often kind of user has different responsibilities and professional standards in systemic-function.Table 3 outlines the dissimilar of the user expecting this system of use.

operational issue solves

The user of any door may experience a little problem in use portal interface and instrument, and needs the User support of certain form to deal with problems and to safeguard suitable service level.Particular importance in patient's participation is being safeguarded in this service.This type of ability can comprise teaching screen and FAQ, Video chat support and guidance and upload fastening means.

Numerous function that door design comprises for strengthening operating performance and report, this may occur with the time arranged regularly and interval.The non-limiting example of control activity comprises normal data library backup and relevant control, user safety management and support, report schedule and distribution, for Email and the integrated coordination of Information Mobile Service, and system form and tool maintenance.

In order to support the operation transparent degree of greatest hope, in the multiple stakeholder's demand of support, function of the present invention can be supported audit widely and manage surveillance coverage.System features can comprise management and agree to the log recording of function, the log recording that inquiry and data set are downloaded, and goes to and leave the log recording of all messaging services of the present invention.

Function of the present invention can be provided for all data processings and the visual and complete quality control agreeing to operation.System features can comprise the data element to all loadings quantitative tracking, comprise the inbound data type in scope and territory validity, to the counting of all feeds of data with hold the control of sum and the confirmation Message recover signature for all outbound traffic.This platform can be supported to use HealthLevel7 communication standard and all Standard Editions of reference model and the messaging service of current version.

platform management and control device

Platform management and control device be allow being used for starting, kit that the metadata required for data that loads and manage this platform defines, derives or loads, ensure instrument together with for the one group of internal soundness verified and optimize metadata definition.Management and control device attempts to make to need the rank of the management and control to data and message to maximize, and comprise data to the mapping of the set of Ontology and aligning, it can complete automatically when minimum manual analysis is intervened.This feature allows the data source be incorporated in platform to regard as configurable, instead of requires to load each new data source, to require the implementation of its oneself hard coded after intensive analysis efforts.

The management and control device of platform comprises various functional module.Service available in this ability and the non-limiting example of order comprise following content.Message mapper: be used for defining the metadata for inbound messages type that is new or change.By platform, this assembly supports that employee makes for definition data and by structurally the definition of message being resolved into fragment by data-mapping in this system, described fragment can be mapped in the concept and function CLO (ConceptualandFunctionalCLO) defined platform discretely.Token manager: be used for identification data, needs the privacy protecting described data in platform.Any data of the central registration identifier (CRID) be mapped to directly or indirectly in information workpiece body can be protected, and support the clearly tagged any additional data of employee by platform equally.Body loader: be used for defining, loading and safeguard outer body, this is due to the concept CLO (comprising the impact analysis as the element in body and configuration report) in platform, may affect function or concrete CLO maps or example.Ontology expansion device: be used for defining and safeguard by body loader or the local attribute of body by loading the mapping of source message and process.This function safeguards the internal relations body of " tokenized device (Tokenizer) " and " framing scaffold omniselector (the ScaffoldNavigator) " ability of driving.Ontology Mapping device: be used for classifying to the relation between concept and function CLO in summary and mapping, and be conceived to message constructing (that is, ICE, IQE) and how be mapped to concept.Can identify and solve message to the inconsistency between body and body, comprise those of conflict be derived from during body loads and safeguards inconsistent.Instance management device: be used for managing the example that may stand the concept safeguarded by data source, particularly tokenized structure (such as, patient merges, and contact is mobile), the example of wherein said concept is from described data sources.Process comprises to be followed the tracks of and resolves natural source key, described natural source key not yet by management and control as unique and arrive in the source data be associated with the key of a more than unique management and control.Mode construction device: be used for inferring to derive from the source message mapping to CLO needed for the data structure of content.This comprises for the data structure of concrete CLO and for the data structure of any outbound message of part becoming platform future.Framing scaffold omniselector: be used for allowing the inquiry of writing for an Ontology, extend to other body concept be suitably mapped to.

message mapper

" message mapper " is used for defining the metadata for inbound messages type that is new or change.By platform, this assembly supports that employee makes for definition data and by data-mapping in system, described fragment can be mapped to discretely the concept and function CLO that define in platform by structurally fragment being resolved in the definition of message.

The value of management and control mapper makes can maximizing according to the some parts of available structure and deduction automatic mapping in message definition or example corpus of each new information.Ideally, the exception that occurs during needing only to focus on other side automated procedure of management and control device.Automatically can optimize by introducing manual management and control chance in whole management and control process.Some embodiments not only comprise automatic management and control but also comprise manual management and control.

Identifying the message that makes new advances so that when being input in platform, those message delivering to management and control device can be defined as completely new message categories (direct " being (isA) " offspring of IAOIBE concept) or as the variant of message of certain previous definition being derived from IAOIBE concept.To organize the definition of specific industry standard message can be derived from its based on industry standard message definition, this industry standard message definition itself is the direct offspring of IAOIBE concept.

The structure defined for any super categories IBE message technically can be inherited by any new IBE message with being mapped in, but may violate this inheritance for the manual management and control of real world message definition.Therefore, when IBE being defined as subtype each other, can ensure to analyze to find inconsistency or find difference on the brother obtained between type of message and the subtype message of deduction by implementation quality.

Figure 10 illustrates such as some in the complicacy of the destructing of the IBE of the XML standard and so on of CDA document.Concern is the entity with variable implication.If the metadata be associated provides concrete CLO and corresponding attribute CLO, described attribute CLO has the value for the concern be present in identified label, then concern state is considered as solving.This concern can be alternatively the concrete CLO of the attribute with embedding, the age that the attribute of described embedding such as shows effect, such as 57 years old.This concrete CLO can embed/inherit the CLO in the lower level of described mapping, and concludes this concern to problem list, which results in gathering fragment annotation.

Some source fields have its assembly by coding and the value that maps of label, and other field is found to be in the value in existing identification label.The all of this complicacy can occur in nested coding structure, and described nested coding structure illustrates the difference in functionality assembly of negative assorted message arbitrarily.

The information workpiece body objectives in management and control device are used to be by message being resolved into the structure and content components that can map relative to other bodies, and resolve into can during message management and control the CLO pattern of Dynamic Definition, come with system and manageable these complicacy of mode process and variable.

This management and control kindization can with two differences below but the role supported work: 1) by being conceived to formal definitions instead of the content of type of message, such as HL7CDA standard, or 2) by being conceived to message corpus to extract actual mapping from True Data, and mapping injects Row sum-equal matrix to manage difference in the natural variant in corpus between message or inconsistency.The former scheme has the advantage not having message variant to be processed, and the latter's scheme has the advantage that there is actual True Data to map.Due to the actual content that the many mappings in medical treatment and nursing message are Effect-based operation processes, therefore, the scheme based on corpus most possibly causes being used for driving the final mapping of ETL process.Mapping more based on formalization standard can serve as important middle mapping, maps other mapping based on corpus of support in the middle of described.These replacement schemes still will be explored to determine preferred plan.

identity information carrier

In message structure, management and control can be carried out as information content entity (ICE, InformationContentEntity) in any path through evaluating.Many labels in message represent-by CDA standard indicate-do not need the message expense that is loaded in platform, but some in these data are useful in auxiliary management and control process.This observation block identification is observe at the CDA age by TemplateID.State code indicates this observation and completes.

ICE also stands the additional management and control layer in IAO, this additional management and control layer comprise can prove management and control self support and help by platform to useful in both automating ETL process of these message.Example comprises carries out management and control using unit ICE (UnitICE) as chronomere (TimeUnit) as time measurement data using ValueICE.

definition protection

Some data protections provided by platform are by defining ICE kind relative to OBI body.Particularly, some ICE are mapped to individuality and organize identifier or patient's role conception, and therefore easily enter the platform of these values tokenized.

Data demand under HIPAA as the protection of PHI data; This is for no other reason than that it is not address, but because it is the address (hospital address such as, with upwards included in the head in message is contrary) comprising the patient role directly on it at its path definition in ICE.By management and control device, the ISE for address structure assembly can be masked as PHI.

token manager

Token is the internal identifier of platform, and described internal identifier permission goes markization to the data from each mechanism's origin system arrival.Be desirably in platform and comprised two continuous things identifiers by the type of tokenized message components, such as MRN; Temporal events identifier, it will be unique for so continuous things, such as contact or Access Identifier; And the operation mark symbol in those temporal events, such as sequence number.

Need to define the relation preference level between source identifier and those source identifiers to token management, described source identifier needs the token be converted in platform.Platform has the identifier of one group of definition, described identifier is built into level to process.The root of this level is enterprise master control people identifier (EMPI, EnterpriseMasterPersonIdentifier) of platform, distributes and safeguard that this enterprise controls people's identifier (EMPI) in this platform.Other node can be defined by the management and control device carrying out work and to be mapped to by source data element system.

Such as, the identifier for three different institutions definition below can be there is: hospital/health care facility, federal health care facility and the local mechanism specified.Set at this identifier, different mechanisms has its oneself branch, if but identical identifier share between multiple mechanism and can occur (such as, social security number) in the multiple positions in this tree.

Branch of each mechanism can start from the identifier used as master identifier by this mechanism.Ripe mechanism can have the singular id symbol that they treat as EMPI, but platform does not retrain the number that mechanism can carry out the identifier of management and control as EMPI.The EMPI identifier of mechanism is the additional non-EMPI identifier of level cascade below, and this additional non-EMPI identifier is unique or not unique.

token--identifier

Usually, can carry out tokenized to causing any data identifying the concrete CLO be associated with OBI patient role or sample role in platform.In addition, can carry out tokenized to the data being defined as the example registering ID (CRID) concept with the IAO center of organizing or sample identifier is associated in platform.The latter's identifier of these centers registration can also require to make and be included in tokenized algorithm to safeguard the uniqueness of tokenized identifier in platform the tissue of the distribution of such identifier.

manage conflict

Numerous contradiction and conflict may be caused between the concept mapped to the automatic management and control ability of platform.Some are intrinsic occurring across the inconsistency of body between each body owing to being loaded in platform.Other problem may cause due to the ambiguousness of the message of management and control self and inconsistency.Mankind's management and control device can address these problems clearly.

iCE is mapped to CLO

Outside structure mapping, the ultimate object of management and control process is in platform storage vault, complete the mapping of inbound messages value to specific function CLO.Much message comprise enough metadata in case can automatically management and control this finally link, and other message values map by the manual management and control based on the mankind.This management and control process can resolve to create initial or middle model proposal to many type of messages in addition automatically, input field is mapped to concept and function body, and defines concrete CLO scheme attribute.

body loader

" the local loader " of platform be used for for any to can be used in the public or privately owned body loaded can all nodes and relation to expand concept CLO.This comprises the original upload of new body and the routine maintenance of existing prestrain body.

ontology expansion device

Across any body be stored in platform, complete management and control requires that the body to loading is expanded comprise local node, relation or otherwise be not identified as the ability being in other intrinsic example.Two most important purposes in these abilities are the place of inferring local body in message mapper from message content, and the existing relation between node needs amplification with the place making their behaviors as required in framing scaffold omniselector.

ontology Mapping device

The framing scaffold ability of platform is by searching for allow during satisfied request to be supported by self-navigation the inquiry that user makes for data from the concept of multiple body or semantic level to data.Although the many mappings between body as the routine maintenance of the body loaded a part and be loaded in platform, management and control device is also for supporting that employee provides a kind of mechanism of those relations that clearly increase.

Be mapped between these bodies in platform and may be used for various object.Figure 11 be between body semantic concept map schematically show.This diagram depicts the contingent Different matching rank when processing search.Other illustrated examples of matching stage comprises exact match, close to coupling, narrow coupling and relevant matches, wherein each can facilitate final mapping relations independently or jointly.Mapping between Ontology can support abundanter enquiry navigation by inquiry framing scaffold function.To the mapping support of support body based on inquiry object to from the including in or getting rid of of data analyzed.

Map to the concept normally message independently workpiece of IAO body, and usually do not pass on information that is clinical or research character.The concept mapping to OBI concept typically passes on the information of the clinical setting (setting) about the data just derived, but the concept mapping to OBI concept is not typically the part that great majority are oriented to the clinical picture of the patient interested to clinical inquiry.Map to the element of concept typically in the inquiry of platform in interested patient clinical picture of OGMS body.

All in these data may be interested in any ad hoc rules or inquiry, and therefore all available in platform; But map to support body to provide for optimizing the path what comprises or get rid of in many inquiries.Semantic concept to multiple support body intersection map additionally provide for the quality control of data and the extensive chance of modeling in case towards continuation improve map and work.

Map to additionally provide and implement the chance that his-and-hers watches are shown in the preliminary quality guarantee of the semantic data in the body of loading.Management and control instrument needs mark and the common issue indicated relate to the two-way inconsistency in the Semantic mapping between concept.

instance management device

Can as time goes by the example of the data be loaded in platform, particularly tokenized example manages, to guarantee continuously appropriate mapping and definition.Most of health care facility needs to merge the patient's definition created redundantly routinely, or the mobile contact (encounter) defined for wrong patient.Instance management device provides automatically for these abilities and manually both management and control support.

orphan manages

It is automatic that most of orphan adoptes, and occurs according to when its external source once upgrades at the body comprised.Not that those orphans automatically adopt by this way can remain on orphanhood, except non-manual management and control.Manual management and control is like this optional, but contributes to this concept being linked to larger mapping available on the conceptual network of platform and management and control data set.

scheme constructs device

" the scheme component device " of platform be used for inferring to derive from the source message mapping to CLO needed for the data structure of content.

framing scaffold omniselector

" the framing scaffold omniselector " of platform is used for allowing the inquiry of writing relative to an Ontology to be expanded to other body, management and control instrument wherein in body self or by providing in this platform of use, concept has suitably been mapped to other body described.Navigation determines to comprise which limit, or must get rid of which limit by body from framing scaffold path, wherein navigates to pass downwardly through described concept typically and include concept in towards narrower.

The given CLO as focus, framing scaffold omniselector can follow the limit away from this CLO; To set up its framing scaffold neighbours, these neighbours comprise all CLO along a limit.Can get rid of from navigation the limit that focus CLO is widened, only be retained as definite, closely or the departures limit of constriction relation and management and control.

Each step in framing scaffold process comprises treatment step, and this treatment step can be included based on from using the input of the query facility of framing scaffold or get rid of from framing scaffold algorithm.For any given inquiry, this framing scaffold is typically seen as and opens or closes, but the assembly that actually can comprise this algorithm is up to any degree; Thus provide the dirigibility of increase and functional for the user of query facility of any support.

The starting point of framing scaffold logic is to comprise by the concept of management and control as the exact match of protonotion to the expansion of the concept of any inquiry.The definite matching relationship of directly tracing to the source between concept using the part as any body load operation, or as the definite result of management and control in this suite of tools.Because exact match relation is transferable, therefore some concepts return redundantly, thus require the mechanism for stopping any recurrence produced by concept-search.Be simple neighbor queries for the Minimal Realization mode of carrying out needed for framing scaffold, thus cause only seeing those concepts recorded as exact match, and do not attempt following transferable exact match relation further.

demand data

Platform " management and control device " uses three high level Ontologies, and wherein each is mapped to basic citation form body (BFO).Figure 12 depicts three bodies in the body that platform uses and how data flow to the next one from a body.Information workpiece body (IAO) comprise utilize platform functionally by for follow-up mapping message definition resolve into the necessary concept of other semantic frame and relation.Body (OBI) for biomedicine investigation comprises and appropriately defines and catch the data necessary concept relevant with biomedical environment and the activity that occurs there and relation.The data mapped by this body describe the participant of clinical setting, role and action.The body (OGMS, OntologyofGeneralMedicalScience) of general medical science comprises the necessary concept of the clinical picture of catching patient or main body and relation.By data actual clinical state describing patient or main body in certain of this Ontology Mapping.

These three bodies can by platform extension to support other other described body and common or functional requirement in this disclosure everywhere.

token storage vault

" the token storage vault " of platform is for will carrying out tokenized and being unified into the source message identifier that standard platform EMPI defines and providing protection.This storage vault is that each different right key that is derived from safeguards granular token, is also even like this after many such keys being mapped to the same instance of patient.This granularity allows token to keep stable, even token to different patient mapping may the time changes at any time time also be like this.The assembly in token store storehouse illustrate in fig. 13 and herein as service available in this ability and order non-limiting example and describe.They comprise: token mechanism: have or control by the tissue of tokenized identifier or body.Its fundamental purpose guarantees that all tokenized contexts are uniquely defined, and seem that similar reference value does not repeat or conflicts from multiple mechanism.Token context: be used for the definition of each identifier used by enterprise showing data.Master control index (EMPI) (it can be unique) is used as at least one in the context of mechanism.Other context of this same mechanism can be unique or not unique, and can carry out assembling one of the EMPI up to mechanism.Token maps: the relation between mechanism's context.Token reference: the contextual example of mechanism.Token defines: actual token and the controlling value of distributing to the one group of reference pointing to it.Token level: the relation between reference example.

During processing for each with reference to distributing its oneself platform token.The layout of this level determines how to process data at loading duration.Carry out tokenized relative to available minimum rank token to the data (such as, hospital and MRN) in the multiple contexts received simultaneously.

Not exclusive context demands is unwanted extra process for unique context.Comprise not exclusive contextual data feed if having received, then both received one of value and unique identifier can be used to feed to these data and verify.This additional authentication can ensure by mistake not to be associated with wrong EMPI for the data of non-unique identifiers.

for clinical support facility and the application of analyzing DNA/rna gene group data

Platform of the present invention can analyze the CLO comprising genomic information.Genomic information such as can obtain from main body in mode below.1) in Manganic pyrophosphate complex initiation, amplify in the water droplet comprising single DNA template to DNA, this single DNA template is sent to the pearl scribbling primer in oil solution.Nucleotide is added in growth sequence, and the interpolation of each base (base) is proved by visible ray.2) ionic semiconductor order-checking is according to the electric signal be associated with the hydrogen ion of releasing between synthesis phase, detects the interpolation of nucleic acid residue.The nucleotide construction block comprising the responsing well Four types of template is full of, often next.The timing of electric signal identifies to the addition of which structure block, and identifies residue corresponding in a template.3) DNA nanosphere uses rolling cycle replication so that DNA is zoomed into nanosphere.The non-chain type order-checking undertaken by the colligation to nanosphere discloses DNA sequence dna.4) in reversible dyestuff scheme, nucleic acid molecules is annealed to the primer on microslide and nucleic acid molecules is amplified.Add the fluorescent dye residue of Four types, each complementary with natural nucleobases, add the residue with next base complementrity in nucleotide sequence, and rinse the dyestuff be not incorporated to from microslide.Add the reversible termination base (RT-base) of Four types, and wash out the nucleotide be not incorporated to.Fluorescence indicates the interpolation of dyestuff residue, thus identifies the complementary base in template sequence.Chemically remove dyestuff residue, and repeat this circulation.Genomic data, once obtain, just can carry out searching for and analyzing together with the available any data of this platform and CLO.Genomic data may be used for personalized clinical care, research and population analysis/discovery object.

Any instrument, interface, engine, application, program, service, order or other executable project can as providing with the module of computer-executable code coding on a computer-readable medium.In some embodiments, the invention provides coding wherein and have the computer-readable medium of computer-executable code, this computer-executable code is encoded to the method for performing any action described herein, wherein the method comprises the system providing and comprise any number module described herein, and each module performs any function of the result being used for providing such as output and so on to user described herein.

Embodiment

Embodiment 1: exemplary data stream

Fig. 1 shows and directly carries out metadata collecting from medical care network, hospital or patient self with each rank.Use network go-between, go markization to defer to patients ' privacy and HIPAA standard to data.Then take in these data, described data comprise streaming data with promote in post-processed object intelligent (ObjectIntelligence) phase data to normalized number according to definition mapping.In addition, the existing body in this software is applied to the data of new input to create object in the object intelligent stage.

As depicted in Figure 1, the object intelligent stage comprises object generator (ObjectGenerator), object store (ObjectWarehous), rule management and natural language processing (NLP) engine.These assemblies allow the generation of object, storage, analysis, maintenance and distribution.In this, this software is the modern Application DLL (dynamic link library) (API) that developer and researcher provide viewing content.The object intelligent stage creates a group objects instrument that can be used for analyzing further object of interest.Object intelligent can by more newly arriving improvement to platform via application programming interface (API) or software development cover bag (SDK).

The dynamic whole data stream that Fig. 1 illustrates software platform two-way is that data not only flow into the object intelligent stage, and flow out outside this stage using as the method being used to provide clinical Service supportive.Clinical Decision Support Systems (CDS) can be adopted, send engine at this Clinical Decision Support Systems (CDS) via message and make recommendation about patient care to user.What these message can be shown in original user-health care network, hospital and/or patient is any.

Figure 14 illustrates the example that how workflow can carry out when analyzing Patient charts.Be a trigger action to opening of Patient charts, this trigger action impels and instructs rule (BPGR, BestPracticeGuidanceRule) to assess to best practices.This assessment can occur via the health care search server of specifying.For BPGR assessment the second trigger point be used to patient output and sign doctor's advice (order) time.When perform one of these trigger points or both time, data are collected, and initiate the calling to risk assessment engine.Risk analysis engine to be assessed together with other patient data this input and is determined whether to need to show warning to user.If return "false" from engine, then workflow terminates.If return "True", then show warning to user, this warning not only comprises the concern specific to this patient, but also comprises set of option, and described option can be suitable for the doctor's advice (order) of patient for sending.Now user can accept to instruct and terminate this workflow, or accepts the doctor's advice collection of suggestion.If have selected the latter's option, then download this doctor's advice collection from health care research server and be shown to user.

Embodiment 2: computer architecture

Various computer architecture is suitable for using together with the present invention.Fig. 3 is the first exemplary architecture illustrating the computer system 300 that can be combined with example embodiment of the present invention.As depicted in figure 3, example computer system can comprise the processor 302 for the treatment of instruction.The non-limiting example of processor comprises: the processor of Intel Corei7TM processor, Intel Corei5TM processor, Intel Corei3TM processor, Intel XeonTM processor, AMDOpteronTM processor, Samsung 32 RISCARM1176JZ (F)-Sv1.0TM processors, ARMCortex-A8 Samsung S5PC100TM processor, ARMCortex-A8 apple A4TM processor, MarvellPXA930TM processor or function equivalences.Multiple execution thread may be used for parallel processing.In some embodiments, can in single computer systems, in the cluster, or on the network comprising multiple computing machine, cell phone and/or personal digital assistant equipment Spanning system trooping of carrying out distributing, use one or more processors with multiple core.

data acquisition, process and storage

As illustrated in figure 3, high-speed buffer 301 can be connected to or be incorporated in processor 302 so that for being provided high-speed memory by the instruction of processor 302 use recently or frequent use or data.Processor 302 is connected to north bridge 306 by processor bus 305.North bridge 306 is connected to random access memory (RAM) 303 by memory bus 304 and manages the access to RAM303 by processor 302.North bridge 306 is also linked to south bridge 308 by chipset bus 307.South bridge 308 and then be connected to peripheral bus 309.Peripheral bus is such as PCI, PCI-X, PCIExpress or other peripheral bus.North bridge and south bridge are usually called processor chip set and data transmission between peripheral assembly on management processor, RAM and peripheral bus 309.In some frameworks, can the function of north bridge be incorporated in processor instead of use independent north bridge chips.

In some embodiments, system 300 can comprise the accelerometer card 312 being attached to peripheral bus 309.Accelerometer can comprise field programmable gate array (FPGA) or other hardware for accelerating certain process.

(one or more) software interface

Software and data to be stored in external storage 313 and can be loaded in RAM303 and/or high-speed buffer 301 and use for by processor.System 300 comprise for management of system resource operating system and run application software on an operating system; The non-limiting example of operating system comprises: the operating system of Linux, WindowsTM, MACOSTM, BlackBerryOSTM, iOSTM and other function equivalence.

In this example, system 300 also comprises the network interface unit (NIC) 310 and 311 being connected to peripheral bus and other computer system that may be used for distributed variable-frequencypump, described network interface unit (NIC) 310 and 311 for being provided to the network interface of external storage, such as network-attached reservoir (NAS).

computer system

Fig. 4 is the diagram that network 400 is shown, network 400 comprises multiple computer system 402a and 402b, multiple cell phone and personal digital assistant 402c and network-attached reservoir (NAS) 401a and 401b.In some embodiments, system 402a, 402b and 402c can management data reservoirs and optimize data access to the data be stored in network-attached reservoir (NAS) 401a and 401b.The mathematical model for data can be used and distributed variable-frequencypump can be used to assess mathematical model across computer system 402a and 402b and cell phone and personal digital assistant system 402c.Computer system 402a and 402b and cell phone and personal digital assistant system 402c can also be provided for the parallel processing reconstructed the self-adapting data of the data be stored in Network Attached Storage (NAS) 401a and 401b.Fig. 4 illustrate only an example, and other computer architecture and system can be combined with each embodiment of the present invention widely.Such as, blade server can be used to provide parallel processing.Connection handling device blade can be carried out to provide parallel processing by backboard.Reservoir also can be connected to backboard or as the network-attached reservoir (NAS) by individual networks interface.

In some embodiments, processor can be safeguarded independent storage space and can by network interface, backboard or other connector transmission data for the parallel processing by other processor.In some embodiments, some or all of in processor can use shared virtual address storage space.

virtual system

Fig. 5 is the block diagram using the multiprocessor computer system sharing virtual address storage space.This system comprises multiple processor 501a-f that can access shared storage subsystem 502.This system is incorporated with multiple programmable hardware memory algorithm processor (MAP) 503a-f in memory sub-system 502.Each MAP503a-f can comprise storer 504a-f and one or more field programmable gate array (FPGA) 505a-f.MAP provides configurable functional unit, and the some parts of specific algorithm or algorithm can be supplied to FPGA505a-f in case with each self processor close cooperation process.In this example, can by all processor global access for each MAP of these objects.In one configuration, each MAP can use direct memory access (DMA) (DMA) to visit the storer 504a-f be associated, thus allows it independent of respective microprocessor 501a-f or execute the task asynchronously with it.In the configuration, result directly can be fed to another MAP to the channelization of algorithm and executed in parallel by MAP.

Computer architecture above and system are only examples, and other computing machine, cell phone and personal digital assistant framework and system widely can be combined with example embodiment, comprise and use general processor, coprocessor, FPGA and other programmable logic device, SOC (system on a chip) (SOC), the system of any combination applied in specific integrated circuit (ASIC) and other process and logic element.The data storage medium of any kind can be combined with example embodiment, comprise random access memory, hard disk drive, flash memory, tape drive, disk array, network-attached reservoir (NAS) and other local or distributed data reservoir equipment and system.

In example embodiment, the software module of any upper execution above computer system can be used in or in other computer architecture and system realizes.In other embodiments, system function can partially or even wholly with the programmable logic device (PLD) of the field programmable gate array quoted in firmware, such as Fig. 5 (FPGA) and so on, SOC (system on a chip) (SOC), apply specific integrated circuit (ASIC) and other process and logic element realize.Such as, processor and optimizer group can utilize hardware-accelerated by using the hardware-accelerated meter card of all accelerometer cards 312 as illustrated in figure 3 and so on to realize.

Embodiments of the present invention described herein such as can be manufactured and transmission by the user in same geographic location.Product of the present invention such as can manufacture and/or transmission from the geographic position a country, and user of the present invention may reside in different countries.In some embodiments, by the data of system access of the present invention be the computer program that can be transferred to user 602 (Fig. 6) from one of multiple geographic position 601.The data generated by computer program of the present invention can carry out transmission back between multiple geographic position, such as, transmitted by network, secure network, insecure network, the Internet or Intranet.In some embodiments, at physics tangible product encodes to body layer level provided by the present invention.

Embodiment 3: use the MO mapping of human diseases (DOID) body

User's choice for use DOID body searches for morbid obesity.User carries out searching for and provides as the row synonym as shown in table 4 to user.Retrieve project by being compared by the Ontology Mapping model of searched for project and platform, this platform identification goes out the synonym in multiple body level.In the case, synonym is morbid obesity, morbid obesity (disorder) and severe obesity.In addition, search for other ontology database shown for the cross reference to this project, as shown in table 4.Finally, DOID demonstrates the level of this project, and it not illustrate only the project of specifying, but also shows former generation, as illustrated in Figure 15.In this example, minimum project of specifying is " metabolic disease ", and it finally causes body to set project-" morbid obesity " of extremely specifying at most.This level discloses the obesity that morbid obesity is the type dropped under overnutrition kind.Overnutrition is a kind of nutrient responsive diseases dropped under obtained metabolic disease, thus former generation-" the metabolic disease " of guiding body tree.

Embodiment 4: use the mapping of the hearing loss of human phenotype (HP) body (former generation)

User performs search for hearing loss in HP body.Table 5 shows the result obtained by the Ontology Mapping module of consultation platform.The definite synonym determined by this body is presented to user; In this case, auditorily handicapped is the synonym of hearing loss in HP body.This search have found the project of equal value in UMLS body.

Figure 16 illustrates the level created when user searches for for hearing loss.Figure 16 shows the highest former generation that organs abnormality is hearing loss, and hearing loss is the hearing exception of a type, and it is the exception of ear, and it is organs abnormality.

Embodiment 5: use the mapping of the hearing loss of HP body (offspring)

After searching for hearing loss in HP body, user wishes to know that what disease drops under the territory of hearing loss.Figure 17 illustrates the downward expansion of level.User can see all offspring's projects of the hearing loss comprised in HP body, and direct parent's project of hearing loss-" hearing is abnormal ".The child of the hearing loss comprised in HP body is for deaf, hearing loss (conduction), hearing loss (sensory nerve), congenital hearing loss, Progressive symmetric erythrokeratodermia hearing loss, the hearing loss of sensory nerve, conduction or mixing, the sensorineural hearing loss of congenital, non-Progressive symmetric erythrokeratodermia, non-syndrome, high frequency hearing loss, low frequency hearing loss, and serious auditorily handicapped.

Embodiment 6: the work flow diagram of doctor's case

Clinical user, doctor G has the position female patient of 72 years old, and this patient suffers from diabetes, hypertension, high fat of blood, lupus and CVA history.First trigger event of workflow is that it opens the contact with this patient.This triggers two rules, these two rules are transferred into platform of the present invention.Output null response, thus do not have message to be shown to doctor G.Doctor G inputs the doctor's advice to patient then, and triggers the rule not producing warning when so doing.Then doctor G obtains patient history and checks this patient.After inspection, doctor G endorsed for Plavix ^tMdoctor's advice.This doctor's advice is a trigger event.Inspection code for warning triggers a platform rule, and this platform rule presents to doctor G by way of caution.Doctor G then as this warning change Plavix with being advised ^tMdosage.This change is a trigger event not producing warning again, and this is the dosage of therefore institute's typing is acceptable.Doctor G closes this contact.To contact closedown be last trigger event, this last trigger event does not produce warning.Workflow terminates.

Embodiment 7: utilize systematic direction clinical effectiveness of the present invention

Within 44 years old, Caucasian male (main body A) just accepts nursing at hospital A.Clinician B just treats main body A.Main body A tells clinician B, and main body A is just suffering extreme facial pain.This clinician diagnoses main body A to suffer from disease-trigeminal neuralgia.Trigeminal neuralgia is the situation be associated with high-level pain.This clinician thinks the standard care treatment prescription opening 100mg Tegretol (Tegretol).

By clinician, prosopalgic diagnosis is added in the electronic health record (EMB) of patient, during the CLO prosopalgic diagnosis having been added to main body A troops.The interpolation of this new diagnosis triggers the rule again evaluated called and troop to the CLO of main body A.Other CLO in the electric health record of the phenotype of this system evaluation main body A, genotype, demography, prescription drug record and main body A.This system determination main body A carries the genotype be associated with excessive risk, described excessive risk for horse oxcarbazepine (Tegretol ^tM) seriously and sometimes fatal dermoreaction.This system is to this clinician of clinician B output notice and the message opening the risk that horse oxcarbazepine prescription is associated to main body A.This system exports the message recording content below further: " prescription of alternative medicine is opened in consideration.All medicines are proved to be for be used in trigeminal neuralgia and not know to affect by the Drug Discovery profile of this theme below: a) Gabapentin (Neurotin ^tM); B) lyrica ((Lyrica ^tM); And c) amitriptyline (Elavil ^tM).”。Prescription label for each therapy is provided as the link that can click and consults when needed for clinician A by this message.This clinician selects and opens the lyrica of recommended treatment effective dose to main body A.

After taking lyrica and reaching the time period of specifying, main body A turns back to hospital A to follow up a case by regular visits to clinician B.The symptom of main body A has improved and main body A tolerance prescription drug is good.The resolution of symptoms of main body A and drug tolerance are added in the electronic health record (EMR) of this patient by clinician B, and therefore these data are reacted automatically in the CLO of this patient in platform.This platform is learnt the treatment results of main body A and is used the clinical decision in this message notice future.

Embodiment 8: search item diagram in graphical user interfaces.

Figure 18 describes the illustrative search interface being used for platform.In this example, user wishes to identify the male patient of the specific SNP had in CYP2C19, and this male patient has started an Effect of Clopidogrel in Treating myocardial infarction course for the treatment of (MI) in 1 year.First, the male patient of user search age between 55 to 89.Intersection operation symbol only returns the result of those male patients of age between 55 to 89, and this demonstrates the such patient of existence 3846.User specifies the genotype of SNP and expectation further in CYP2C19; Intersection operation symbol returns 112 results.Next, user makes search constriction further by the patient suffering from acute MI (ICD410) at least one times in request in the previous year; This returns 10 results.In addition, user adds the search condition for the patient taking clopidogrel, and this returns 1496 results.Meet and specify the final output of all standards of search inquiry to obtain a patient.Described search item graphically illustrates, instead of writes with text-string, which improves efficiency and this platform is of value to have the novice users of minimum clinical or IT training.

Embodiment

Following non-limiting example provides illustrated examples of the present invention, but does not limit the scope of the invention.

Embodiment 1.In some embodiments, the invention provides and comprise every method below: a) receive search item; B) the result clinical concept identified by the first standardization body level is identified based on described search item; C) know in the second standardization body level acceptance of the bid the clinical concept correspondence, the clinical concept of wherein said correspondence has the clinical definition with the clinical definition basic simlarity of described result clinical concept; D) by the database of computer processor based on the clinical concept search electric health record of described correspondence; E) in the database be associated with described corresponding clinical concept, electric health record is identified; And f) Output rusults.

Embodiment 2.Method as tdescribed in embodiment 1, is also included at least 10 other standardization body level acceptances of the bid and knows the clinical concept correspondence.

Embodiment 3.As the method according to any one of embodiment 1-2, also comprise and identify main body colony, described main body colony comprises the clinical concept of the described correspondence in the electric health record of each main body of described colony.

Embodiment 4.Method as described in embodiment 3, wherein said colony comprises the main body identified based on described first standardization body level and the main body identified based on described second standardization body level.

Embodiment 5.As the method according to any one of embodiment 1-4, wherein said Output rusults provides the clinical decision support based on described search.

Embodiment 6.As the method according to any one of embodiment 1-5, also comprise the instruction receiving and create rule based on described Output rusults.

Embodiment 7.Method as described in embodiment 6, wherein activates described rule when search item described in user's typing or when having with the clinical definition of described search item basic simlarity a clinical concept.

Embodiment 8.Method as described in embodiment 6, wherein activates described rule when refresh circuit health records.

Embodiment 9.Method as described in embodiment 6, wherein said rule warns risk to user.

Embodiment 10.Method as described in embodiment 6, described search item is associated with genomic information by wherein said rule.

Embodiment 11.In some embodiments, the invention provides the method comprising the following: a) select to search prime modulus block on the graphic alphanumeric display of computer system; B) locate by the part that the first dialog box moved to described graphic alphanumeric display described first dialog box be associated with selected search module; C) the first search item is input in described first dialog box; D) the second dialog box is positioned on described graphic alphanumeric display; E) the second search item is input in described second dialog box; F) on described graphic alphanumeric display, illustrate the logical operator described first dialog box be connected with the second dialog box; G) based on the database of described first search item, described second search item and described logical operator search electric health record, the processor be wherein associated with described computer system by analyzing described first search item, graphics relationship between described second search item and described logical operator determines search strategy; And h) receive the output of Search Results.

Embodiment 12.Method as described in embodiment 11, also comprises the addition item identifying and have basic simlarity clinical definition with described first search item.

Embodiment 13.As the method according to any one of embodiment 11-12, also comprise and create rule based on described first search item.

Embodiment 14.Method as described in embodiment 13, wherein when the described electric health record of renewal triggers described rule for the moment.

Embodiment 15.Method as described in embodiment 13, wherein triggers described rule for the moment when upgrading described electric health record by the risk factors be associated with described first search item.

Embodiment 16.As the method according to any one of embodiment 13-15, wherein trigger described rule when creating new electric health record.

Embodiment 17.As the method according to any one of embodiment 13-16, wherein said rule is encoded to the warning will transmitted when described rule is triggered.

Embodiment 18.As the method according to any one of embodiment 13-17, the relation of wherein said rule description between genomic data and the risk factors be associated.

Embodiment 19.As the method according to any one of embodiment 13-17, the relation of wherein said rule description between phenotypic data and the risk factors be associated.

Embodiment 20.As the method according to any one of embodiment 11-19, the wherein said part described first dialog box being moved to described graphic alphanumeric display comprises and drags and put down described first dialog box.

Embodiment 21.As the method according to any one of embodiment 11-20, wherein said graphic alphanumeric display comprises snap to grid (snap-togrid).

Embodiment 22.As the method according to any one of embodiment 11-21, one of wherein said electric health record is electronic health record.

Embodiment 23.As the method according to any one of embodiment 11-22, one of wherein said electric health record learns record for electronic medicine.

Embodiment 24.As the method according to any one of embodiment 11-23, also comprising based on described output is that main body recommends to intervene.

Embodiment 25.In some embodiments, the invention provides the method comprising the following: a) provide graphic alphanumeric display on the computer systems; B) reception is used for utilizing removable dialog box to expand the instruction of described image display; C) search item for each removable dialog box is received independently; D) instruction described removable dialog box be connected with logical operator figure is received; E) database based on described search item and described logical operator search electric health record is received; F) graphics relationship between described search item and described logical operator is analyzed by the processor be associated with described computer system; G) search strategy is determined based on described analysis; H) database of described electric health record is searched for; And i) export the result of described search.

Embodiment 26.Method as described in embodiment 25, also comprises the addition item identifying and have with described first search item basic simlarity clinical definition.

Embodiment 27.As the method according to any one of embodiment 25-26, also comprise the input receiving rule, wherein said rule is based on described first search item.

Embodiment 28.Method as described in embodiment 27, wherein when the described electric health record of renewal triggers described rule for the moment.

Embodiment 29.Method as described in embodiment 27, wherein triggers described rule for the moment when upgrading described electric health record by the risk factors be associated with described first search item.

Embodiment 30.As the method according to any one of embodiment 27-29, wherein trigger described rule when creating new electric health record.

Embodiment 31.As the method according to any one of embodiment 27-30, wherein said rule is encoded to the warning will transmitted when described rule is triggered.

Embodiment 32.As the method according to any one of embodiment 27-31, the relation of wherein said rule description between genomic data and the risk factors be associated.

Embodiment 33.As the method according to any one of embodiment 27-32, the relation of wherein said rule description between phenotypic data and the risk factors be associated.

Embodiment 34.As the method according to any one of embodiment 27-33, wherein said graphic alphanumeric display comprises and is adsorbed to grid.

Embodiment 35.As the method according to any one of embodiment 27-34, one of wherein said electric health record is electronic health record.

Embodiment 36.As the method according to any one of embodiment 27-35, one of wherein said electric health record learns record for electronic medicine.

Embodiment 37.As the method according to any one of embodiment 27-36, also comprise and export based on described the intervention recommended for main body.

Embodiment 38.In some embodiments, the invention provides and comprise every method below: a) receive and utilize additional clinical information to the renewal of the electric health record of main body, wherein said electric health record comprises the genomic data of described main body; B) relation between described additional clinical information and the described genomic data of described main body is assessed by computer processor; C) associating between described additional clinical information and the described genomic data of described main body is identified; And d) to report between described additional clinical information and the described genomic data of described main body described associates.

Embodiment 39.Method as described in embodiment 38, the association identification between wherein said additional clinical information and the described genomic data of described main body goes out the neurological susceptibility of described main body to risk.

Embodiment 40.As the method according to any one of embodiment 38-39, the association identification between wherein said additional clinical information and the described genomic data of described main body goes out described main body to the neurological susceptibility of intervening.

Embodiment 41.As the method according to any one of embodiment 38-40, the association identification between wherein said additional clinical information and the described genomic data of described main body goes out the resistibility of described main body to risk.

Embodiment 42.As the method according to any one of embodiment 38-41, the association identification between wherein said additional clinical information and the described genomic data of described main body goes out described main body to the resistibility of intervening.

Embodiment 43.As the method according to any one of embodiment 38-42, also comprise the intervention recommending for described main body based on the report associated between described additional clinical information and the described genomic data of described main body.

Embodiment 44.As the method according to any one of embodiment 38-43, the described electric health record also comprising main body described in warning user upgrades with additional clinical information.

Embodiment 45.Method as described in embodiment 44, wherein said warning provides clinical decision support.

Embodiment 46.As the method according to any one of embodiment 38-45, also comprise and stop described additional clinical information to the renewal in the described electric health record of described main body.

Embodiment 47.In some embodiments, the invention provides and comprise every method below: a) to the renewal of computer system input to the electric health record of main body, wherein said electric health record comprises the genomic data of described main body, and wherein said renewal provides additional clinical information; B) report associated between described additional clinical information and the described genomic data of described main body is received, wherein said association is by determining the assessment of the relation between described additional clinical information and the described genomic data of described main body, and wherein said assessment is performed by the processor of described computer system; And c) receive the report associated between described additional clinical information and the described genomic data of described main body.

Embodiment 48.Method as described in embodiment 47, the association identification between wherein said additional clinical information and the described genomic data of described main body goes out the neurological susceptibility of described main body to risk.

Embodiment 49.As the method according to any one of embodiment 47-48, the association identification between wherein said additional clinical information and the described genomic data of described main body goes out described main body to the neurological susceptibility of intervening.

Embodiment 50.As the method according to any one of embodiment 47-49, the association identification between wherein said additional clinical information and the described genomic data of described main body goes out the resistibility of described main body to risk.

Embodiment 51.As the method according to any one of embodiment 47-50, the association identification between wherein said additional clinical information and the described genomic data of described main body goes out described main body to the resistibility of intervening.

Embodiment 52.As the method according to any one of embodiment 47-51, also comprise the intervention recommending for described main body based on the report associated between described additional clinical information and the described genomic data of described main body.

Embodiment 53.As the method according to any one of embodiment 47-52, also comprise and receive warning, wherein said warning provide with the relevant suggestion of the renewal of described additional clinical information to the described electric health record of described main body.

Embodiment 54.Method as described in embodiment 47-53, wherein stops described additional clinical information to the renewal in the described electric health record of described main body.

Claims (10)

1. a method, comprising:

A) search item is received;

B) the result clinical concept identified by the first standardization body level is identified based on described search item;

C) know in the second standardization body level acceptance of the bid the clinical concept correspondence, the clinical concept of wherein said correspondence has the clinical definition with the clinical definition basic simlarity of described result clinical concept;

D) by the database of computer processor based on the clinical concept search electric health record of described correspondence;

E) electric health record be associated with described corresponding clinical concept is identified in the database; And

F) Output rusults.

2. the method for claim 1, is also included at least ten other standardization body level acceptances of the bid and knows the clinical concept correspondence.

3. the method for claim 1, also comprises and identifies main body colony, and described main body colony comprises the clinical concept of described correspondence at the described electric health record of each main body of described colony.

4. method as claimed in claim 3, wherein said colony comprises the main body identified based on described first standardization body level and the main body identified based on described second standardization body level.

5. the method for claim 1, wherein said Output rusults provides the clinical decision support based on described search.

6. the method for claim 1, also comprises the instruction receiving and create rule based on described Output rusults.

7. method as claimed in claim 6, wherein when search item or typing described in user's typing have the project with described search item basic simlarity clinical definition, activates described rule.

8. method as claimed in claim 6, wherein when upgrading electric health record, activates described rule.

9. method as claimed in claim 6, wherein said rule warns risk to user.

10. method as claimed in claim 6, described search item is associated with genomic information by wherein said rule.